Effects of Exercise and Sleep on Motor Learning and Functional Abilities in Multiple Sclerosis

Condition(s) studied

Investigational drug(s) / intervention(s)

Aerobic Exercise: The Aerobic Exercise Intervention consists of 20 minutes of Graded Exercise Test (GXT) on an ergometer bike. The participants start with 5 minutes of warm-up. The wattload will then be increased until exhaustion.

Daytime Sleep - Nap: The Daytime sleep consists of a 30-minute nap after the acquisition of the visuomotor accuracy tracking task. The participants will be asked to rest in a supine position in a bed in a dark and quiet room.

Study summary

The ExSiMS study is a randomized, controlled crossover study including 20 individuals (18-70 years) diagnosed with relapsing remitting Multiple Sclerosis (MS) This project investigates, through behavioral and neurophysiological measurements, how aerobic exercise on an ergometer bike and sleep in the form of a nap and overnight sleep may enhance cortical motor skill learning evaluated by a complex hand motor skill test and thereby improve functional capacity in individuals with MS. Beyond the effect on motor skill learning, the project investigate the effect on electroencephalography (EEG) - electromyography (EMG) coherence.

The study hypothesizes that individuals with neurological conditions, such as multiple sclerosis (MS), may experience beneficial effects on specific motor rehabilitation through systematically planned cardiovascular exercise and sleep scheduling, due to positive impacts on memory consolidation.

Aims:

* Investigate the brain's neurophysiological responses and memory effects following a training intervention and, separately, sleep, in the form of a power nap, in individuals with MS.
* Examine whether these effects persist beyond the few days previously observed in healthy individuals by implementing a longer-term intervention.
* Explore whether the training effect is influenced by disease activity in the brain, such as during relapses and during immunosuppressive treatment.
* Assess whether the presence of abnormally reduced cognitive endurance (fatigue) affects the impact of the intervention involving exercise and sleep.

The study is based on documented positive effects of physical activity and sleep in both young and older adults, as well as in individuals recovering from stroke. The research thus offers promising perspectives for broader applications within neurorehabilitation, and particularly for MS, as the disease is associated with functional impairments. At the same time, both physical exercise and sleep represent meaningful interventions that should be thoughtfully integrated into rehabilitation strategies.

Eligibility

Primary outcome measure(s)

• Motor/Skill Learning — Assessed on experiment days 1, 2, 3 and 4.
  Visuomotor accuracy tracking task. Online and offline effects. Unit: Range from 0 (lowest) to 100 (highest) percent.
• Neurophysiological Measurement I - Cortical Activity — Assessed on experiment day 1, 2, 3 and 4.
  Cortical activity will be measured with electroencephalography (EEG) during skill acquisition. Unit: EEG Power in several frequency bands.
• Neurophysiological Measurement II - Muscular Activity — Assessed on experiment day 1, 2, 3 and 4.
  Muscle activity will be measured with electromyography (EMG) during skill acquisition. Unit: EMG amplitude.
• Neurophysiological Measurement III - Corticocortical Functional Connectivity — Assessed on experiment day 1, 2, 3 and 4.
  Corticocortical functional connectivity will me measured as functional coupling in EEG during skill acquisition. Unit: functional coupling in EEG (scale 0-1).
• Neurophysiological Measurement IV - Corticomuscular Functional Connectivity — Assessed on experiment day 1, 2, 3 and 4.
  Corticomuscular functional connectivity during skill acquisition will be measured with functional coupling between EEG and EMG. Unit: functional coupling in EEG-EMG.
• Neurophysiological Measurement V - Muscular Functional Connectivity — Assessed on experiment day 1, 2, 3 and 4.
  Muscular functional connectivity during skill acquisition will be assessed using EMG-EMG coherence between M. Abductor Pollicis Brevis and First Dorsal Interosseus. Unit: EMG-EMG coherence (0-1)

Trial sites (2)

More Zealand University Hospital trials in Denmark

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